[摘要] 目的 探讨巨大脑膜瘤的术前评估、手术入路、手术方式，总结治疗效果。方法 回顾性分析36例巨大脑膜瘤患者的临床表现、影像学资料、手术切除程度。结果 患者平均年龄51.6岁。主要临床表现是头痛、头晕、呕吐、癫痫，步态不稳，视乳头水肿。肿瘤全切(SimpsonⅠ、Ⅱ级切除)31例(83.3%)，次全切5例(13.9%),死亡1例。随访33例(91.7%)，恢复工作28例，生活自理4例，生活不能自理1例。3例次全切除者随访3年，未见肿瘤生长，1例次全切除者术后2.2年残余肿瘤继续生长，因家庭经济困难未考虑再次手术。结论 术前根据肿瘤的位置、周围结构确定手术入路，先瘤内分块切除，再从瘤周分离，可以减少出血，提高肿瘤全切率。

    [关键词] 脑膜瘤；手术

    Surgery treatment of enormous meningiomas

    BAI Xi-min,DANG Jun-tao,YAO Sheng,et al.Department of Neurosurgery,Weinan Central Hospital,Shanxi 714000,China

    [Abstract] Objective To explore former operation evaluate,the surgical approach,resection way of largenees meningiomas and summarize the effect of treatment.Methods A retrospective study was done on 36 patients with enormous meningiomas.The clinical presentation,neuroradiological data,the extent of resection analysed.Results The average age was 51.6 years.The common clinical manifestation were headache,head dizzy,vomit,epilepsia,gait ataxia and hemianopia.Total removal(Simpson group I and II) in 30(83.3%) patient subtotal removal in 5(13.9%) and one patient died.33(91.7%) cases were followed-up,28 cases were resumed work,4 cases were resumed normal life and 1 cases was not able to self life.Three cases with subtotal removal were followed-up for 3 years,no residual tumor progression.One case of subtotal removal was followed-up for 2.2 years,has residual tumor progression and no reoperation for no money.Conclusion Surgical approach according to the site and the surrounding structure of the tumor,first removed in tumor then separated around tumor.Achieved the goal reduce bleeding and raised the rate of tumor for total removal. ......